As a practicing clinician specializing in the adult diagnosis of Autism Spectrum Disorder (ASD), I have noticed that as the diagnosis of children impacted on the spectrum has dramatically increased (current statistic from the Centers for Disease Control is 1:55), the first time diagnostic rates for adults on the spectrum also continue to skyrocket, making the demand for effective couple therapy a clear necessity.
ASD (in one or both partners), is a core challenge in marriage and needs to be both acknowledged and appropriately addressed. The adult Autism Spectrum Focused Couple Therapy Model is a flexible approach that combines therapeutic interventions that proved effective for both individual adult Autism Spectrum therapy and general marital therapy.
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Highlights of the model:
1. Educating about Autism Spectrum Disorder
The therapist methodically explains how the diagnosis is made using lay terms to describe scientific highlights and pausing frequently to answer questions and then details the various treatment option and strategies available to the couple.
2. Clarifying partner’s perspectives
When ASD has long gone unrecognized or misunderstood, couples tend to ‘fill in the blanks’ with distorted explanations. Couples now learn to reframe their long-running challenges and potential solutions through the ‘ASD’ lens.
Example: Carla mistakes Arthur’s challenge of helping her with domestic chores as passive-aggressive behavior. Arthur misinterprets Carla’s criticisms as ‘controlling.’ The therapist works with the couple to identify and correct ingrained dysfunctional patterns into more productive interactions.
3. Helping couples monitor medication (if needed)
Many prescribing physicians offer only short appointments. Therapists are not pharmacologists, but they can guide the couple to work as a team in getting the best results from medication. This includes identifying ‘treatment targets’ (behaviors that will respond to medication) and monitoring progress over time.
4. Guiding couples in creating new, practical habits
Autism Spectrum Focused Couple Therapy strongly focuses on the practical; that is, developing cooperative strategies around previously frustrating behaviors, e.g., poor communication/social skills, lack of a continuous reciprocal relationship, anger management. The therapist also helps each partner break through each point of resistance in establishing new habits.
5. Teaching couples to communicate effectively and empathically
The therapist coaches the couple through a structured, turn-taking dialogue in which both partners can be heard and understood without criticism or interruption. The couple practices this dialogue, with several variations between sessions until it becomes second nature.
6. Developing pragmatic strategies for co-parenting
Much has been written about parenting children on the spectrum, with little or no emphasis on helping parents on the spectrum to parent effectively. Often, these parents can forget rules and routines, or conversely become too rigid in the regimentation of house standards. With the parent’s help, the couple can implement ASD supportive guides to routines and eliminate conflictual arguments with and about their children.
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7. Addressing the couples other particular challenges
Challenges not be overlooked include various concerns that may include sexual intimacy, financial management, cyber-addictions, and even denial of an ASD diagnosis, along with other issues stemming from other aspects of either partner’s personality or the couple’s circumstances.
Using the types of approaches described here, many couples finding themselves challenged by ASD can improve their relationship satisfaction and regain the intimacy they once enjoyed. They can also learn the skills to continue problem-solving and working together long after therapy ends.
This article was featured in Issue 58 – The Greatest Love of All: Family
